A Silent Wish.

When those around us need help

When those around us are in pain.

We should listen for the sounds , when they ask again,we should watch for the signs.

For we may have missed their silent call for care.

We may have missed the very essence of their need, and slowly they disappear.

They may be our patients, they may be our colleagues.

 It could be us, as we send a silent wish.

We all spend so much time - reaching out with kindness and care, that even in the deepest times of despair and discomfort - we miss the importance of what is being said.

I have spent many months this year calling to my colleagues, picking up the banton of patient first and experience-  waving it frantically at times.

Sometimes it is taken and great things have happened- and at times it has fallen to the floor.

Over this last year there have been huge strides, and there have been times for me that have been so difficult and distructive, that some days I have felt like I have carried the biggest of boulders in my bag.

Throughout the year I have grown, discovered a strength deep within,that I didn't think was there, have collaborated with inspiring peers- and have learnt that being true to what you believe and feel is both freeing and frightening in equal measure.

I recall a conversation with a family. 

"You see Sian it's easy to "act" like you are giving the best performance of your life, but really you want and need the permission to strip that costume and at times  feel naked and all consumed in order to let it all out"

I thought about how honest this family had been with me- how trust plays a huge part of patient care and support.

Then I reflected on my month, my year.

I thought about how do we really allow families to feel free enough to be able to strip away there performance - and allow us to see the core of need.

I haven't got all the answers- but I know that one way could be providing an environment that allows honesty and opportunities - that listens and that doesn't promise the magic wand action.

I have been reading lots and collaborating with great minds- I have also been listening - and taking time to explore authenticity- and how this impacts patient care.

My silent wish for the new year- to continue with planting those seeds- of providing them with food and fuel- of nurturing them and supporting the start of the growth.

Wishing you many moments of peace, joy and happiness in equal measure.

Sian.

Conversations that matter.

"Vulnerability is not a weakness, and the uncertainty, risk, and emotional exposure we face every day are not optional.
Our only choice is a question of engagement."
Brene Brown 2012.

When we work with and engage with children, young people and their families we are seeing them at there most exposed, raw, and vulnerable.
As health care professionals, we may walk alongside them, to offer a hand or to simply listen and to help carry that emotional suitcase that is at bursting point, but we do not have the power to make everything better- for it all to go away.

But we can impact the experience.

It is at this point we engage with them, and those first moments need to be as honest and kind as possible- however having walked alongside many I feel that as an individual I have to also be at my most exposed and at times vulnerable.

I don't know what they will ask me, or what they want help and support with?
I don't know what path we shall walk, and if there may be many twists and turns in it.
Brene Brown  talks about choices and Daring Greatly- I feel that as an individual I dare greatly most days, I also observe my colleagues do this sometimes on a hourly basis.
As health care professionals we have codes of conduct, pathways and policies to follow that are there not only to protect ourselves - but also to ensure the safety of patients and clients we work with.

But they do not mention over exposure or vulnerability as we would understand it- so we have to make sure we have pathways in place to support us as professionals. 

But sometimes we are thrown curveballs- and we don't see them coming,  however experienced we are.
Having conversations that matter are all exposing and engagement is the key, without it the most important elements are missed, and the family or individual you are caring for also gets lost in the unknown.

I recall some recent conversations with a family, the things that matter, the vulnerability of the conversation - the courage shown to talk - and to say the most emotively charged things, in a space that can be held- in the middle of a busy ward environment - it was not easy, but it was spontaneous, and organic in its content.
How do we know what to do and say in these moments?

I can only share my experiences- and over the past few weeks I have had to spend time looking at my vulnerability and to not be afraid of it, to have the courage to expose it to some of my colleagues.
It can sometimes be misread, it is can also at times become over consuming- and feels quite alien to me.
To feel in a vulnerable state, also throws up feelings of anxiety, being frightened, out of control, unsure, and can be exhausting.

Recalling tough conversations that matter with children and young people, and their families, these feelings are expressed in many different ways, but when striped back their sense of feeling exposed and vulnerable- translates into fear and anger as they are unable to control what happens next.

Conversations that matter can be minutes in length, seconds, it can be a comment as you engage in an activity , whilst doing observations, walking past- but the impact may be powerful.
Over the last 8 years- I have watched as large groups of doctors approach children and young people at bedside.
Those that decrease in size.
Say hello to the child/young person.
Ask how they feel.
 They are the ones who dare greatly, and have courage to hold the vulnerable - which equally transforms the relationship, the art of it.

The parents and families we work with are exposed to the very core.
 To have a sick child in hospital, and not know what's happening- or what day of the week it is.
 They have emotional suitcases that are bursting at the seams.

In order for us to support them, we need to be supported.

Vulnerability is not a weakness, it is a true strength, our children and families will feel a great sense of this when in hospital- so our conversations that matter will invite that strength to be exposed, and we will do our best to bring purpose and meaning to events for them- hearing the unheard, and being ok with that.


Sian Spencer-Little.

In Health, In Trauma, Play is essential.

Play is an essential component, it is instinctive and powerful- in the development of the whole child and must continue wherever possible in sickness and in ill health, trauma and both when there are long or short term issues.

It is critical and crucial in helping to support children and young people - to provide coping strategies and opportunities to explore, to find out

the mechanisms of why we each react differently to environments and procedures.

All members of the team whether that be in healthcare, support work, overseas volunteering are involved in the wrap around care elements of children and young people within health/aid settings they can utilise play and it's components.

Members of the Specialised Health Play Team hold enhanced responsibilities, experience and rich knowledge to share and promote essential skills.

Judy Walker shared with us that essential functions of play are built into the fabric of the child and young persons journey through the hospital and health experience.

Normalising Play is at the very centre of a child's world- to have it removed - to have been part of a traumatic experience or for play to be unobtainable means to deprive and remove the ability to explore, engage and experience.

Children and Young People accessing hospital and health care often feel disjointed from the experience- when I talk about this I also want to include the following.

Recent world challenges throws up questions.

I wonder how children and young people feel ,who have had to leave the place they know, the people they know, where they play, to be led away to travel, on such a long and at times frightening journey- How do they feel?

To leave their homes without the adults whom they love and trust who provide a safe loving feeling.

They may have lost the ability to play and in turn are not able to express or play out their worries?

They may have become so shut down and withdrawn that to experience joy, have fun, or smile- is lost.

This will have a huge impact on the way they develop, grow and for their stories to be told- we have to listen, sometimes to the unheard- and sometimes this takes a long time.

Listening to the unheard is often difficult - for the HCP's involved - but how difficult and frightening for the child or young person and their families to tell it- to let us into their inner world.

We have to do this within healthcare too- to assist the healing journey of trauma - to past experiences and look at how it impacts the future of their care.

It's important when working with children, young people and their families that we look at how long a hospital stay will be, will they need regular input within a clinical environment .

Individual Play Programmes are a way of listening to what they have to say- how treatments make them feel- what works well for them to support preparation and distraction- likes and dislikes.

A lengthy stay in hospital or repeated hospital admissions may lead to a decline in reaching developmental milestones - Developmental Play Programmes can help and support to address this.

 They are formulated to ensure delelopmental progress is maintained, and opportunities to explore,have fun and maximise learning in a non- threatening way.